Supplier
Main Street Pharmacy 3 LLC
Main Street Pharmacy 3 LLC was paid $17K by Medicaid between Mar 2018 and Oct 2024, across 7 billing codes. Its largest line is A5501, For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe — 22% of everything it billed.
33Billing provider infoMAIN STREET PHARMACY 3 LLC
BRIDGEPORT, CT 06610
BRIDGEPORT, CT 06610
33aNPI1316249352assigned 11/24/2010
33bProvider typeDurable Medical Equipment & Medical Supplies
28Total paid$17K
24GClaims417
24DCodes billed7
24AFirst – last monthMar 2018 – Oct 2024
Compared with peers
Next to other Durable Medical Equipment & Medical Supplies providers in Connecticut
Rank by total paid#192 of 310
Median peer was paid$31K
This provider vs. median0.5×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 80 | $3K | |
| 2019 | 90 | $4K | |
| 2020 | 54 | $3K | |
| 2021 | 14 | $600.15 | |
| 2024incomplete | 179 | $7K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| A5501 | For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe | 22% | 34 | 12 | $4K |
| L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | 21% | 84 | 70 | $3K |
| A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | 14% | 56 | 53 | $2K |
| E0114 | Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips | 13% | 73 | 64 | $2K |
| A5512 | For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each | 13% | 80 | 32 | $2K |
| L3670 | Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf | 11% | 25 | 25 | $2K |
| A5500 | For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe | 5.7% | 65 | 18 | $952.74 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialJACOB, JEAN (OWNER)